65 | Rely On the Labs

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"Coming through!" someone yelled and we all turned to the elevator as it opened.

"Webber's pulse is thready." Bailey called out, "Systolic's eighty. Brooks has massive head trauma. Pupils are unresponsive."

Just as Bailey stopped talking, Heather started to seize on the stretcher. "Let's get her on her side." Derek rushed over, "Ready? One, two, three, go. Get her for a C.T. Ross? Ross! Let's go. Go!"

"V-Tach." Bailey looked down at Webber, "Um, give me one of epi. Come on. Come on."

"Charge to one-twenty." Cristina took the panels, "Clear."

After the first shock, there was still no change. "Okay, charge to two hundred." Cristina sighed, "Clear."

It was all going well. Sure, a massive storm had raged on through the night and we were swamped with patients then, and even now when we had no supplies we were holding strong. But in a matter of minutes, everything had fallen apart. The story was Webber had gone down to check on the generator and the mechanic, and with all of the flooding, one wire that fell down into the puddles had shocked the mechanic, then Webber, and then Brooks.

The mechanic had been found last night, but after the crowds of incoming Traumas this morning, no one thought to go back down into the basement and see if anyone else had gotten electrocuted. Webber had been victim to massive amounts of electricity through his body, but Brooks, along with being shocked, had hit her head on one of the metal power boxes as she fell.

As much as I wished I could stay behind and help, I had surgery with April and Owen.

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"Okay, forceps." Owen looked to the scrub nurse.

I glanced up, "Metz."

"I have a status update on Dr. Webber." a nurse walked in.

"Okay." Owen nodded.

"Dr. Yang is attempting to place a balloon pump, but he keeps coding," she informed us.

Owen scrunched up his forehead in confusion, "She's placing one bedside without fluoro? She could rupture his aorta."

"Do you want me to get Dr. Yang on the phone?" the nurse offered.

"You just said that she's threading a balloon pump." Owen reminded her.

The nurse nodded, "She is, but-"

"Then how is she gonna talk on the phone?" Owen asked.

"I didn't...mean-" the nurse stuttered before turning and leaving.

Owen huffed, "Retract her."

"Oh, no." April said out loud, "No, no, no."

"Okay, let's run the bowel," I spoke up.

"The abdomen's fully contaminated." April sighed.

"Just run the bowel." Owen told her, "We're gonna resect this and get out of here. Let's get ready to pack him. Come on, Lenny."

"He's bleeding through the packing, and there's still stool coming out" April moved quickly as we tried to get Lenny out of there.

Owen looked down into the cavity, "Damn it. We need to take it out and resect more intestines."

"How's his I.N.R.?" I questioned.

"The last one was six," Knox told me.

Owen nodded, "Okay, give him factor VII, F.F.P.s and platelets. Faster, guys."

"He's having arrhythmias," Knox announced.

Owen looked up, "Talk to me."

"Uh...I can't get a pulse." Knox huffed, "I think he's in P.E.A."

"Starting compressions," Owen announced.

"P.H. is down to 7.12," Knox told Owen as he continued to give Lenny compressions.

Owen looked up at the monitor, giving it the look of hope that it might magically change any second now, "Come on, Lenny."

"He's been down twenty minutes." I reminded Owen even though I didn't want to believe it myself.

"Did you say 'Yes'?" Owen looked to April.

April raised an eyebrow, "Sir?"

"To Matthew. I helped with his proposal." Owen breathed out as he tried to keep Lenny alive.

"Oh, uh, yeah." April nodded, "Yes. I said 'Yes.'"

Owen smiled under his mask, "Good. I like him. He's a good guy. I mean, these guys - these first responders - they're all good guys. Hate to give up."

As the monitor let out the all too familiar high pitched beep, Owen backed away from the table and exhaled. Lenny had flatlined. "Damn it, Lenny." Owen said under his breath as the phone went off in the E.R., "Time of death...fifteen fifty-six."

"It's Dr. Karev." the nurse picked up the phone, "The firefighters are asking for an update."

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"Chaplain's on his way to tell Marla and the girls." one of the police officers, Brain, got off the phone and joined the large crowd of officers and firefighters. "She's gonna wanna come in and see him." another man said.

"Absolutely." Owen nodded, his arms crossed across his chest.

Brain looked around the crowd, "Let's bring her in. Full lights and sirens."

"On it." an officer agreed as he took off.

"Lauenstein's still missing." the woman officer in the bed spoke up, "We gotta bring him back. We gotta do that for Lenny. If I could walk, I'd be out on that pile."

Just then Owen's pager went off and he motioned for me to follow him. "Excuse us." Owen looked to the group before we both took off.

"Oh, Owen." Cristina stood up as we entered Webber's room.

Bailey looked up and stopped Cristina, "Owen, no. You're not gonna 'Owen' this. No personal relationships. This is professional. This is Dr. Hunt."

"What is going on?" Owen asked.

"Dr. Webber has an acute abdomen." Bailey started, "He needs surgery."

"He barely survived the balloon pump," Cristina argued.

Bailey pushed on, "His lactate is six..."

"And holding." Cristina interrupted.

"So what if it's holding?" Bailey shot back, "Something is dead inside of him. It's not gonna get undead."

Cristina shook her head, "It is way too risky, and you know it."

Bailey turned to Cristina, "I would rather take the risk than just wait for what we know is gonna kill him."

"Stop, stop." Owen tried to calm things down, "What does his healthcare directive say about extraordinary measures?"

Bailey and Cristina looked to each other; neither having a clue about what Webber's healthcare directive said. So, the four of us headed down to the file room, which I had never even been in before. It held all necessary paperwork for all staff in the hospital and probably some other complicated stuff, too.

"Whoa. I smell dead people." Cristina commented as soon as we entered the room.

Bailey looked around, "Oh, and spiders. Dead people killed by spiders."

"Okay, let's find his personnel file," Owen said as he turned on the lights; which flickered on and off as a soft buzzing noise started up in the background.

"Oh!" Cristina stepped over to one of the many filing cabinets, "Okay, I, uh, got it. Webber." she pulled out the file and flipped through it, "Oh, no."

"What, he doesn't have a healthcare directive?" Owen asked.

Cristina closed the file and looked to us, "No. He has one."

"I don't understand," Meredith said as she flipped through the file.

Owen sighed, "Richard designated you as his medical power of attorney."

"But he can't make me next of kin without talking to me first," Meredith argued.

"He did," Bailey told her.

I nodded, "After Adele died, he revised his directive."

"But-"

"Meredith, I know this is a shock, but we don't have much time." Owen reminded her, "Right now you need to make a decision."

"His heart is too weak, Meredith." Cristina tried to prove her point.

Bailey shook her head, disagreeing as expected, "His heart can take it. You trust me, right? You named your baby after me."

"Hey. Hey! No personal relationships." Cristina used Bailey's words against her.

Bailey hushed her, "The amount of electricity he had in his body should have killed him instantly, but it didn't, which tells me that the heart damage isn't as bad as you think."

"He coded four times." Cristina growled.

Bailey nodded, "And we got him back!"

"Oh, and now you just sound idiotic." Cristina accused.

"Ah-ah! Dr. Yang!" Bailey warned.

"No, seriously. You sound like a family member who googled 'electrocution' and is trying to remain optimistic." Cristina said.

Bailey took a breath, "Well, I am optimistic."

"Well, Richard should have made Bailey his family member, because that is how she's acting right now." Cristina sighed.

"I wish he would've." Bailey rose her voice.

"Well, he didn't. He put Meredith down." Owen spoke up.

Meredith looked to us, "Why would he do that?"

"And she knows as well as I do that electric shock can cause death of tissues which could start a whole new inflammatory cascade unless I debride what's been damaged." Bailey tried to sell Meredith on her plan.

Cristina huffed, "Well, he'll have to handle it for a day to let his heart rest. And then-"

"He can't handle it?" Bailey looked to Cristina, "Okay, now you sound like an idiot. Letting that tissue die is like taking a gun and killing him."

"Why wouldn't he tell me?" Meredith asked again.

Cristina turned to her, "I don't know, but he didn't. And it's on you, so you have to decide, Mer."

Bailey nodded, "Yes. Meredith, please."

Taking a deep breath, Meredith looked down at Webber's file. "You know what I was thinking before you guys came in here?" Meredith asked us, "I was thinking I wish my mother were here to see my kids. I was wondering if she'd make a good grandmother. But you know what that is? That's delusional thinking. Because my mother would make a horrible grandmother, because she was a horrible mother. So...I'm delusional and hormonal. And I can't trust my delusional thoughts. I have to rely on the labs. So we need to run the lactate again, and if it's above six, we're going to do the surgery. And if it's not, we're not."

Owen nodded and instantly took off to get the labs and the three of us followed soon after.

One of the worst feelings as a surgeon is not knowing what's going on. In med school you're taught so much that you think you know everything about the human body...but then you enter a hospital and realize that you really know nothing. It turns out that you know just enough to keep someone alive, and from there you have to figure out how to make them normal again.

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